Background: Facial synkinesis (FS) is a distressing sequela of facial palsy (FP) characterized by involuntary, simultaneous movements of facial muscles occurring during voluntary facial expressions. Treatment of synkinesis is challenging, and preventive methods are needed.
Aim: This study evaluated the efficacy of physical facial nerve rehabilitation (PFNR) therapy alone vs. PNFR with eyelid surgery to correct lagophthalmos and prevent the onset of synkinesis.
Methods: Twenty five outpatients were randomized to receive either PFNR alone (neuromuscular retraining and Kabat proprioceptive neuromuscular facilitation) or PNFR and early (90 days after FP onset) eyelid surgery (involving a conservative oculoplastic correction for lagophthalmos with epiphora or ectropion). Comprehensive otolaryngological assessments and Magnetic Resonance Imaging (MRI) were conducted. Synkinesis progression was measured using Another Disease Scale (ADS) at baseline, 3-, 6-, 12-, and 24-months post-treatment. The data were analyzed with ANOVA, -test, Chi-Square analyses.
Results: Patients undergoing eyelid surgery with PFNR showed faster ( < 0.001) and better recovery of facial movements ( < 0.05) than patients receiving PFNR alone comparing T0 and T12 ( < 0.0001). No synkinesis were observed in the PFNR plus surgery group while 37% of patients in PFNR alone had synkinesis ( = 0.03). At 24 months, none of the patients in the surgery group presented synkinesis.
Conclusion: Combining early surgical treatment of paralytic lagophthalmos or epiphora with PFNR accelerated functional recovery and reduced synkinesis in patients with FP compared to facial rehabilitation alone. Further investigations in larger populations with long-term follow-up are needed.
Clinical Trial Registration: https://clinicaltrials.gov/study/NCT06538103, NCT06538103.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11445145 | PMC |
http://dx.doi.org/10.3389/fneur.2024.1443591 | DOI Listing |
Int Ophthalmol
December 2024
Department of Ophthalmology, Ankara Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
Purpose: To investigate the efficacy of a comprehensive surgical approach for rejuvenation of the aging lower periorbita.
Methods: Between February 2018 and January 2023, 80 eyes of 40 patients with lower lid dermatochalasis (LLD), lower lid laxity (LLL) or orbicularis laxity of the lower lid (OL) admitted to the oculoplastic surgery department of our clinic were included in the study. 18 eyes had LLD, 14 eyes had LLL, 18 eyes had LLD and LLL, and 30 eyes had LLD, LLL and OL.
J Plast Reconstr Aesthet Surg
November 2024
Department of Plastic and Reconstructive Surgery, Ichikawa General Hospital, Tokyo Dental College, Ichikawa, Japan.
Chemodenervation with botulinum A toxin and neuromuscular retraining therapy are commonly performed as first-line treatments for postparalytic facial nerve syndrome (PFS). However, their effects are temporary, and side effects typically develop. Currently available selective neurectomy approaches are limited by variations in the anatomy of the peripheral branches of the facial nerve and the ability to reduce perioral synkinesis, but not periocular synkinesis.
View Article and Find Full Text PDFJ Craniofac Surg
December 2024
Department of Plastic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou.
Objective: The infrabrow blepharoplasty is a common surgical operation indicated in Asians for periorbital rejuvenation. This operation alone is difficult to achieve the correction of crow's feet. Therefore, the authors elucidate the authors' experiences of applying infrabrow blepharoplasty combined with the subcutaneous undermining of the lateral periorbital region to treat upper eyelid dermatochalasis with lateral hooding deformity and alleviate crow's feet, including its indications, operative procedures, and postoperative outcomes.
View Article and Find Full Text PDFOphthalmic Plast Reconstr Surg
December 2024
Adnexal Department, Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom.
Purpose: Euryblepharon is a rare congenital eyelid malformation characterized by symmetrical horizontal enlargement of the palpebral fissure. The eyelid is shortened vertically compared with the horizontal dimension. The lateral canthus is most commonly affected.
View Article and Find Full Text PDFOphthalmic Plast Reconstr Surg
December 2024
Division of Oculofacial Plastic and Reconstructive Surgery, Shiley Eye Institute, UCSD, La Jolla, California, U.S.A.
Purpose: To describe and characterize shortened fornix syndrome (SFS), a rare complication following posterior-approach ptosis repair using conjunctival Müller muscle resection.
Methods: This retrospective case series evaluates 4 patients who developed SFS after conjunctival Müller muscle resection. Clinical characteristics, surgical histories, management, and outcomes are reviewed.
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